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Full text of "Proposed fiscal … budget: what it means for older Americans"

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95th Congress 1 
1st Session / 



COMMITTEE PRINT 



THE PROPOSED FISCAL 1978 BUDGET: 
WHAT IT MEANS FOR OLDER AMERICANS 



A STAFF REPORT 

PREPARED FOR THE 

SPECIAL COMMITTEE OX AGING 
UNITED STATES SENATE 




%, 



g: 






MARCH 1977 






• 



Printed for the use of the Special Committee on Aging 



84-628 



U.S. GOVERNMENT PRINTING OFFICE 
WASHINGTON : 1977 



For sale by the.Superintendent of Documents, U.S. Government Printing Office 

Washington. D.C. 20402 - Price 35 cents 

There is a minimum charge of $1.00 for each mail order 



SPECIAL COMMITTEE ON AGING 

FRANK CHURCH, Idaho, Chairman 
EDMUND S. MUSKIE, Maine PETE V. DOMENICI, New Mexico 

LAWTON CHILES, Florida EDWARD W. BROOKE, Massachusetts 

JOHN GLENN, Ohio CHARLES H. PERCY, Illinois 

JOHN MELCHER, Montana 
DENNIS DeCONCINI, Arizona 

William E. Oriol, Staff Director 

David A. Affeldt, Chief Counsel 

Val J. Halamandaris, Associate Counsel 

John Guy Miller, Minority Staff Director 

Patricia G. Oriol, Chief Clerk 

(ID 



THE PROPOSED FISCAL 1978 BUDGET: WHAT IT MEANS 
FOR OLDER AMERICANS 

A STAFF REPORT 

President Carter sent a revised budget to the Congress on Febru- 
ary 22, making modifications in President Ford's earlier budget for 
fiscal 1978. 

The committee staff has prepared the following analysis to sum- 
marize the impact of the Carter and Ford budgets on older Ameri- 
cans — including trust fund outlays and discretionary spending. 

Carter Budget Calls for Freeze of Medicare 
Part B Premium 

President Carter proposes to freeze the medicare part B monthly 
premium charge at $7.20 for plrysician and outpatient services through 
September 1978. Under existing law, the premium charge is scheduled 
to rise to $7.70 on July 1, 1977, and to an estimated $8.10 on July 1, 
1978. In the future, premiums for part B supplementary medical 
insurance coverage would be adjusted on October 1 under the Carter 
plan. This proposal would provide $37 million in relief to medicare 
beneficiaries in fiscal 1977 and $182 million in fiscal 1978. 

In addition, the new administration recommends that medicare 
reimbursement be extended to nurse practitioners and physician 
assistants practicing in rural health clinics. 

The budget also calls for legislative actions to allow the Federal 
Government to limit increases in hospital reimbursements under 
medicare and medicaid. However, details were not spelled out in the 
fiscal 1978 budget revisions. 

The revised budget does not include the Ford administration's 
recommendations to change the cost sharing under medicare for 
aged and disabled beneficiaries. The Ford plan would: (1) Require 
medicare patients to pay 10 percent of all hospital charges above the 
inpatient deductible of $124 (medicare beneficiaries now pay the 
first $124 of their qualifying hospital bill and nothing thereafter until 
the 61st day) ; (2) limit a patient's out-of-pocket payments for qualify- 
ing services under part A to $500 per } r ear (increasing afterwards 
proportionately with increases in the hospital insurance deductible) ; 

(3) raise the part B deductible from $60 to $80 in 197S (rising after- 
wards proportionately with increases in social security benefits) ; 

(4) impose a new 10-percent coinsurance charge on hospital-based 
plrysician and home health benefits; (5) limit a beneficiary's liability 
for covered part B services to $250 per calendar year (increasing 
thereafter proportionately with social security benefit increases) ; 
and (6) remove the limits on the number of days in nonpsychiatric 
hospitals and skilled nursing facilities. 

The Carter administration's proposed limitation on hospital cost 
reimbursements would save the medicare part A program almost 
$700 million in fiscal 1978. Under the Ford budget — which would 
place limits on hospital and physician reimbursements as well as 
increase out-of-pocket payments for medicare patients — outlays for 

(l) 



part A would be reduced by SI. 7 billion. Outlays for supplementary 
medical insurance protection would be increased under the CarteV 
budget by $25 million — primarily because of the liberalization in 
benefits which would offset the savings from placing ceilings on 
reimbursement of covered services under medicare. The Ford admin- 
istration's proposed legislation would reduce part B outlays by an 
estimated $69 million. 

HOSPITAL INSURANCE 
[In millions] 

Transitional 
1976 quarter 1977 1978 

actual actual estimate estimate 

Beneficiaries: 

Persons with hospital insurance protection (average): 

Aged. 22.2 22.4 22.6 23.0 

Disabled 2.3 2.4 2.6 2.7 

Beneficiaries receiving reimbursed services: 

Aged. 5.1 1.3 5.3 5.3 

Disabled 0.6 0.1 0.6 0.7 

Benefit payments: 

For inpatient hospital services: 

Aged. $10,531 52,811 $12,829 $14,933 

Disabled 1,216 354 1,650 2,031 

For skilled nursing facility services: 

Aged 303 81 365 425 

Disabled 11 3 14 16 

For home health services: 

Aged 192 61 295 381 

Disabled 14 4 22 28 

Total benefit payments: 

Aged. 11,026 2,954 13,489 15,739 

Disabled 1,241 361 1,686 2,075 

Total 12,267 3,314 15, 175 17,814 

PROPOSED LEGISLATION 

(In billions of dollars] 

Ford budget (savings) 1.7 

Carter budget (savings) 7 

SUPPLEMENTARY MEDICAL INSURANCE 
[In millions] 

Transitional 
1976 quarter 1977 1978 

actual actual estimate estimate 

Beneficiaries: 

Persons enrolled (average): 

Aged 22.0 22.3 22.5 22.9 

Disabled 2.0 2.2 2.3 2.5 

Beneficiaries receiving reimbursed services: 

Aged 12.7 13.3 13.5 14.1 

Disabled 1.3 1.3 1.4 1.5 

Benefit payments: 

For physician services: 

Aged $3,144 $786 $3,862 $4,585 

Disabled 329 91 452 573 

For horns health services: 

Aged 78 26 111 147 

Disabled 3 15 7 

For outpatient services: 

Aged 436 143 623 824 

Disabled 341 120 523 689 

For other medical and health services: 

Aged 312 92 384 452 

Disabled 28 10 39 48 

Total benefit payments: 

Aged.... 3,970 1,047 4,980 6,008 

Disabled 701 222 1,019 1,317 

Total 4,671 1,269 5^999 7,325 



PROPOSED LEGISLATION 

[In millions of dollars) 

Ford budget (savings) 0. 1 

Carter budget (increased benefits) (») 

1 Less than $100 million. The increased outlays to medicare would amount to $25 million. 

Carter Budget Proposes $423.45 Million for AoA Programs 

President Carter's fiscal 1978 budget proposes $423.45 million for 
the Administration on Aging, $21.85 million above the fiscal 1977 
appropriation. However, the budget request is essentially the same 
as the fiscal 1977 spending level for AoA. In fiscal 1977 the title VII 
nutrition program has $21,475 million in carryover funds which is no 
longer available for fiscal year 1978. President Ford's final budget 
recommended $399.65 million for AoA. 

PROFOSED FUNDING FOR OLDER AMERICANS ACT 
[In millions of dollars] 



Fiscal 1977 
appropriation 



Fiscal 1978 



Authorization 



Ford 
budget 



Carter 
budget 



TitJell: 

National Clearing House 

Federal Council on the Aging 

Title III: 

Area planning and social services. 

Administration 

Model projects 

Title IV: 

Training 

Research 

Gerontology centers 

Title V: Senior centers 

Title VII: Nutrition.... 

Total 






O) 

( ; ) 

J287.2 
P) 

CO 

O) 

O) 
O) 
275 


2 

.45 

134 
17 


14.2 
7 


225 


2 


.575 


.45 


122 


122 


17 


17 


12 


12 


14.2 


14.2 


8.5 


7 


3.8 


3.8 


20 


20 


« 203. 525 


225 






401.6 .._. 




399.65 


423. 45 



1 Open-ended authorization. 

2 The $287,200,000 applies to area planning and social services and State administration. 

* For fiscal 1977, the title VII nutritior, program had a $225,000,000 spending level because of the existence of carryover 
funds. 



Nearly 545 area agencies on aging are expected to be funded under 
title III in fiscal 1977. The Ford budget request of $134 million for 
area planning and social services would increase the number of area 
agencies on aging to 548 or 549. But, it would also terminate funding 
entirely for the section 308 model projects program. A $12 million 
appropriation is available for model projects in fiscal 1977: 

FUNDING FOR MODEL PROJECTS 

[In millions of dollars] 

Development of special projects $5. 2 

Nursing home ombudsman development (1. 0) 

Legal services development (1-5) 

Senior environmental employment (1. 2) 

Crime and the elderly (1. 0) 

Ambulatory day care ( 0. 5) 

Institutional development 1.5 

Service innovations ( improve service delivery system) 5. 3 

12. 



Title IV training is now funded at $14.2 million: $6 million for 
approximately 80 career programs in 75 institutions (undergraduate 
and graduate schools), $6 million for 56 awards to State units on 
aging to support in-service training, and $2 million for quality im- 
provement projects, Ph. D. dissertations on aging, and national 
conferences. This allocation of funding is expected to continue in 
fiscal 1978. Both the Ford and Carter budgets propose a $1.5 million 
reduction for research (from $8.5 million in fiscal 1977 to $7 million 
for fiscal 1978). This would reduce the number of projects funded from 
74 in fiscal 1977 to 58 in fiscal 1978. AoA has made five awards for the 
purpose of identhying major policy issues for future policy research: 

Subject Sponsor 

Health and mental health Urban Institute 

Housing University of Nebraska 

Income Urban Institute 

Employment and retirement University of Wisconsin Institute 

of Poverty 
Community services Urban Institute 

The multidisciplinary centers of gerontology program brings 
together research and training capability in selected institutions 
throughout the country. For fiscal 1977, "title IV-C supports 5 im- 
provement grants to ongoing centers and 10 developmental grants 
for new centers. 

AoA plans to make 1,000 awards in fiscal 1977 for the expansion 
or startup of multipurpose senior centers under title V. The mortgage 
insurance and interest grants programs are expected to begin in fiscal 
1977 and continue in fiscal 1978. 

A $225 million appropriation for the title VII nutrition program 
for fiscal 1978 would provide 435,000 meals a day. Nearly 400,000 
meals are now served daily under the nutrition program. For fiscal 
1977, title VII has a $203,525 million appropriation but a $225 million 
spending level because of the existence of carryover funds. 

Funding for the Federal Council on the Aging would be reduced 
from $575,000 to $450,000 in fiscal 1978 under the Ford and Carter 
budgets because of the completion of two studies mandated by law 
(impact of taxation on the elderly and the interrelationship of benefits 
for older Americans). Both the Ford and Carter budgets call for $2 
million for the National Information and Kesource Clearing House. 
This funding would establish three decentralized centers to acquire, 
index, and asbtract new research reports, evaluations, program models, 
experience exchange materials, and other literature in the field of 
aging. The three centers would operate in biomedical, socioeconomic, 
and service delivery areas. A fourth component would be a central 
processing unit to convert the abstracts to microfiche. 

Carter Budget Proposes $50 Special Payment for 
Social Security Beneficiaries 

A $50 special payment for social security, railroad retirement, and 
supplemental security income beneficiaries is proposed in President 
( larter's fiscal 1978 budget. This special payment would be in addition 



to the projected 4.9 percent cost-of-living adjustment for these 
beneficiaries in July. The cost-of-living raise will be based upon the 
increase in the Consumer Price Index (the Government's inflation 
yardstick) from the first quarter in 1976 to the first quarter in 1977. 
The special payment would not be counted as income for purposes of 
Federal or State public assistance programs. 

The House Ways and Means Committee has modified the Carter 
proposal to eliminate the $50 special payment for persons who would 
also be entitled to the $50 tax rebate. Additionally, the Ways and 
Means Committee voted to extend the special payment to (1) veteran- 
receiving disability compensation, pension, and dependency and 
indemnity compensation payments, and (2) persons receiving State 
supplemental SSI payments. 

Social security beneficiaries and benefits. — Nearly 29.1 million indi- 
viduals are expected to receive $78 billion in retirement and survivor 
benefits in fiscal 1978, compared with $71 million in benefits for 28.4 
million persons in fiscal 1977. The number of disabled social security 
beneficiaries is expected to increase from 4.7 million in fiscal 1977 to 
5 million in fiscal 1978. And, benefit payments are projected to rise 
from $10.9 billion to $12.3 billion. 

RETIREMENT AND SURVIVOR BENEFITS 





1976 
actual 


Transitional 
quarter actual 


1977 
estimate 


1978 

estimate 


Beneficiaries (millions): 

Retired workers 

Dependents of retired v/orkers 


16.6 

3.6 


16.9 
3.5 
7.3 


17.3 
3.6 
7.5 


17.9 
3.6 


Survivors. 


7.4 


7.6 


Total beneficiaries. 


27.5 


27.7 


28.4 


29.1 








Benefit payments (billions): 

Retired workers 

Dependents of retired workers . 


$40.6 
4.6 


$11.1 
1.2 

4.5 


$46.8 

5.2 

18.9 


$51.7 
5.6 


Survivors 


16.8 


20.5 


Total benefit payments 


62.1 


16.9 


71.0 


78.0 








DISABILITY BENEFITS 




1976 
actual 


Transitional 
quarter actual 


1977 

estimate 


1978 
estimate 


Beneficiaries (mill ; ons): 

Disabled workers 

Dependents of disabled workers 


2.5 

1.9 


2.6 
1.9 


2.7 
2.0 


2.9 

2.1 


Total beneficiaries 


4.4 


4.5 


4.7 


5.0 


Benefit payments (billions): 

Disabled v/orkers. 

Dependents of disabled workers 


$7.6 

1.7 


$2.1 
0.5 


$9.0 
1.9 


$10.2 
2.1 


Total benefit payments 


9.2 


2.6 


10.9 


12.3 



Ford legislative recommendations. — President Ford's fiscal 197^ 
budget proposed several legislative changes in social security which 
were patterned after recommendations incorporated in his fiscal 1977 
budget. Among the major proposals: 

(1) Eliminate the retroactive payment of actuarially reduced bene- 
fits when an individual would have a permanent reduction in future 



c 

monthly benefit?. Persons electing actuarially reduced social security 
benefits before age 65 may now receive up to 12 months retroactive 
payments. 

(2) Eliminate the monthly test of the social security earnings limita- 
tion, except for the first year an individual receives a cash benefit. 
Persons under 72 may now earn up to $3,000 a year before $1 in bene- 
fits is withheld for each $2 of earnings above the earnings ceiling. A 
beneficiary, though, may continue to receive full social security during 
any month that his monthly earnings do not exceed $250. 

(3) Phase out social securitv benefits for students 18 to 22 years 
old. 

(4) Increase the social security payroll tax rate for emplo3'ers and 
employees, each, by 0.1 percent in 197S — from 6.05 percent to 6.15 
percent. 

(5) Decouple the social Security cost-of-living adjustment mech- 
anism through a wage indexing system. 

Carter legislative recommendations. — The Carter administration has 
deferred action to decouple the social security cost-of-living adjust- 
ment provision, pending further study. The Ford administration 
recommendation to increase the social security tax rate has been with- 
drawn. In addition, the Ford administration's proposal to phase out 
student benefits has been modified to place a ceiling on the amount of 
social security payable to a student — equal to the maximum amount 
payable under the educational opportunity grant program (now 
$1,400). Other Ford administration recommendations (e.g., elimination 
of the monthly feature of the earnings limitation) would be retained by 
the Carter administration. 

Impact of legislative recommendations. — For fiscal 1978, the Ford 
legislative recommendations would reduce outlays by $958 million for 
the old-age and survivors insurance program and by $40 million for the 
disability insurance program — compared with $769 million for re- 
tirement and survivor benefits and $8 million for disability benefits, 
respectively, under the Carter budget. 

Supplemental Security Income Participation Remains 

Constant 

The number of blind, disabled, and elderly Federal supplementary 
security income (SSI) recipients is projected to be 4.4 million during 
fiscal year 1978, the same level as fiscal 1977. Approximately 3.9 
million will receive Federal payments and 0.5 million will receive 
federally administered State supplemental payments. The Carter 
administration estimates $5 billion in Federal payments and an 
additional $1.5 billion in federally administered State supplementary 
payments. SSI recipients are expected to receive a 4.9 percent cost-of- 
living increase for July 1977 and a 5.5 percent cost-of-living increase in 
July of 1978. 

Housing 

Section 202.— Both the Carter and Ford budgets include $750 
million in loan authority for the section 202 program which provides 
loans to nonprofit sponsors of housing for the elderly and handicapped. 
This level of loan authority — the same as approved by the Congn— 
for fiscal 1977 — will finance approximately 25,600 units. 

Section 8 (housing assistance payments program). — The Carter budget 
proposes a fiscal 1978 funding level for the section 8 rental assistance 



program which would support 400,000 units, up slightly from the Ford 
proposal of assistance for 394,000 units. The Carter budget also 
requests a program level of 400,000 units for fiscal 1977, which is 
currently funded at a level to support 240.000 units. 

Of these amounts, 50,075 units for fiscal 1977 and 25,600 units for 
fiscal 1978 are set aside for the section 202 program. (The fiscal 1977 
obligation will meet requirements for both fiscal 1976 and fiscal 1977 
awards made for 202 projects.) 

Community development block grants. — A $4 billion funding level for 
community development block grants is recommended in the fiscal 
1978 Carter budget; the Ford budget proposed $3.5 billion. The fiscal 
1977 funding for this program is $3,248 billion. 

Public housing operating subsidies. — The Carter administration 
recommends increasing public housing operating subsidies for fiscal 
1977 by $10 million to reflect higher utility costs caused by the recent 
cold spell. In addition, the Carter budget recommends a $17 million 
increase for the same purpose in fiscal 1978, and another $14 million 
increase to avoid rental increases for tenents. 

Increased Funds for ACTION'S Aging Progra- es 
Proposed 

President Carter recommends $61.6 million for ACTION'S older 
American volunteer programs for fiscal year 1978, the same level as 
proposed in the 1978 Ford budget. This represents a $4.8 million 
increase compared with the fiscal 1977 appropriations of $56.8 million. 
The increase, however, will not support any additional projects 
be3'ond those in existence at the close of fiscal year 1977. The Carter 
revised budget also restored funding for the VISTA program, which 
had been phased out in the fiscal year 1978 budget proposed by 
President Ford. 

The fiscal 1978 budget recommends $20.1 million for the retired 
senior volunteer program (RSVP), $1.1 million above the fiscal 1977 
spending level. This amount would fund 679 projects with 250,000 
volunteers, compared to 228,000 volunteers in the same number of 
projects in fiscal 1977. The budget recommends $34.9 million for foster 
grandparents — an increase of $900,000 over the fiscal 1977 spending 
level — to support 15,100 participants in 194 programs. Both trie Ford 
and Carter budgets request $6.6 million — an increase of $2.8 million — 
to continue support for 2,600 participants in 43 senior companion 
nrojects. 

ACTION PROGRAMS SERVING ELDERLY 
[In millions of dollars] 









Fiscal 1978 






Fiscal 1977 
appropriation 


Authori- 
zation 


Ford budget 
request 


Carter budget 
& request 


RSVP 

Foster grandparents _ 


$19.0 

34.0 


$22 

35 

8 


$20.1 

34.9 

i6.6 

8.8 


$20.1 
34.9 


Senior companions 

VISTA... 


3.8 

23.0 ... 


'6.6 
2 25.35 











i $6,600,000 requested to continue 43 SCP programs in operation at the end o f fiscal 1977. 52,800,000 increase will 
support 15 new projects originally funded during the 1976 transition quarter which did not require fiscal 1977 budget 
allocations, but will require refunding in fiscal 1978. 

2 Restores VISTA program to fiscal 1977 funding level, including transition quarter funding. During fiscal year 1975, 
approximately 12 percent, or 500, VISTA volunteers were age 55 or over. Many VISTA projects provide services to low- 
income elderly through legal assistance programs, and information and referral and outreach services among others. 

84-628—77 2 



Title IX Program To Increase To 22,600 Exrollees in July 

Both the Ford and Carter budgets request $22.65 million to con- 
tinue the title IX senior community service employment program 
from July 1, 1977, to September 30~, 1978. The effect is to extend 
title IX at an annualized funding level of $90.6 million for the final 
quarter in fiscal 1978. Title IX is now operating at $55.9 million 
through June 30, 1977. 

July 1, 1976-June 30, 1977 



Sponsor Funding Positions 

National Farmers Union.... $22,676,000 6,070 

National Council on the Aging 6, 029,000 1, 618 

National Council of Senior Citizens 12,540,000 3,354 

National Retired Teachers Association-American Association of Retired Persons 9, 156,000 2,457 

U.S. Forest Servite. 4,652,000 1,249 

Alaska, Delaware, Hawaii 501,000 135 

Virgin Islands, Samoa, Guam, Trust Territories of the Pacific Islands 335,000 88 



Total __ 55,900,000 14,971 

Funding increases to $90.6 million on July 1 under the fiscal 1977 
Labor-HEW Appropriations Act. This appropriation, which is 
available from July 1, 1977, to June 30, 1978, will increase the number 
of enrollees in the program from 14,971 to 22,604. Approximately 
18,800 older persons will work in programs administered by the 
national contractors, and 3,800 will participate in State-administered 
programs. 

July 1, 1977-June30, 1978 



Sponsor Funding Positions 



National Farmers Union $30, 976, 000 7, 729 

National Council on the Aging 8,290,000 2,068 

National Council of Senior Citizens 17,108,000 4,268 

National Retired Teachers Association-American Association of Retired Persons 12, 586, 000 3, 140 

U.S. Forest Service 6,406,000 1,598 

Subtotal 75,366,000 18,803 

States 15,234,000 3,801 



Total 90,600,000 22,604 

Senators Eagleton, Kennedy, Church, Chiles, Pell, Nelson, Javits, 
and Clark have recommended that funding be increased to $150 
million in fiscal 1977 — the full authorized amount. This funding 
level would increase the number of participants in the senior com- 
munity service employment program to almost 37,500. 

Title X Jon Opportunities 

Xo funding was requested for the title X job opportunities program 
under the Public Works and Economic Development Act in the fiscal 
year 1978 budget submitted to Congress. Funding for title X which 
was allocated during fiscal year 1975 and now supports a number of 
special emphasis employment programs throughout the country will 
be terminated during fiscal year 1977 unless additional money is made 



9 



available for the program. Title X now supports 71 special emphasis 
projects for older workers through a $21.9 million grant to the Ad- 
ministration on Aging. These projects employ 4,811 older workers. 

Carter Budget Proposes Major Increases in CETA Funding 

The Carter budget proposes SG.528 billion above the Ford admin- 
istration's request for titles I (manpower services), II (structural public 
service employment), III (national programs), and VI (countercyclical 
public service employment). President Carter recommends $8,931 
billion for these four programs, compared with $2,403 billion in the 
Ford budget. Under the Carter budget the number of public service 
jobs is expected to increase from 310,000 to 600,000 bv the end of 1977 
and to 725,000 during 1978. 

COMPREHENSIVE EMPLOYMENT AND TRAINING ACT 
[In billions of dollars] 





Fiscal 1977 - 
budget 
authority 


Fiscal 1973 






Ford 
request 


Carter 
request 


Title 1 (manpower services) 

Title II (structural public service employment) 

Title III (national programs) - 


1.830 

.400 

.239 


1.673 
.4C0 
.330 




1.880 
1.016 
1.180 


Title VI (countercyclical public service employment) 


12.384 


4.855 


Total.... 


4.903 


2.403 


8.931 









' This amount includes $1,334,000,000 under a continuing resolution plus the Ford administration's request of $1,000,- 
000,000 to phase out the title VI program by Sept. 30, 1977. 

Increased Funding for ADEA Sought 

Both the Ford and the Carter budgets would recommend an ad- 
ditional $677,000 for enforcement activities under the Age Discrim- 
ination in Employment Act. from S2.289 million in fiscal 1977 to 
$2,966 million in fiscal 1978. This request would support 91 positions, 
10 more than in fiscal 1977. The Age Discrimination in Employment 
Act has a $5 million authorized funding level. 

Carter Budget Restores Funding for SOS 

Two major CSA programs serving low-income older American? 
which had been eliminated entirely in the last Ford administration 
budget request for fiscal year 1978 have been restored by a revised 
1978 budget submitted by President Carter. 

Senior opportunities and services. — The fiscal 1978 Carter revised 
budget recommends $10 million for SOS, which is designed to identify 
and meet the needs of older, poor persons aged 60 or older. This is the 
same funding level as the fiscal 1977 appropriation. SOS provides 
services to 1 million older persons and employs 2,000 elderly. Xo 
funding was requested in the Ford 1978 budget. 

Community food and nutrition. — The fiscal 1978 Carter-revised 
budget recommends $27 million for the community food and nu- 
trition program, which serves man}" low-income elderly through 
community action agencies with food stamp outreach programs, con- 



10 

gregate meal sites, and meals-on-wheels programs. This is identical 
to the funding level in fiscal 1977. No funding was requested in the 
Ford 1978 budget. 

Emergency energy conservation. — Xo funds were requested in either 
the Ford or Carter 1978 budgets for the emergency energy conserva- 
tion program, which provides funds for weatherization and insulation 
of low-income dwellings and grants and loans to low-income indi- 
viduals for emergency payment of utility bills. The Carter adminis- 
tration has announced its intention to shift this activity to the Federal 
Energy Administration. The fiscal 1977 appropriation was $27.5 
million for October 1976 through March 1977. From July 1975 
through September 1976, $44 million was appropriated to winterize 
150,000 low-income homes, saving approximately $16.5 million in 
fuel costs. 

Community action agencies. — The fiscal year 1978 budget request is 
$330 million, continuing the program at the fiscal 1977 funding level; 
880 community action agencies now provide a variety of services to 
low-income individuals throughout the country. 

Increased Fuxdixg Proposed for SCORE and ACE 

The fiscal 1978 budget recommends an increase of $576,000 for the 
Service Corps of Retired Executives (SCORE) and Active Corps of 
Executives (ACE) programs, from $1.3 million in fiscal 1977 to 
$1,876 million. Approximately 9,600 retired executives will be sup- 
ported through the Small Business Administration for their volunteer 
activities as advisers and consultants for businesses and corporations. 
The increase in funding would expand the program from 300 to 400 
local chapters. 

National Institute of Mental Health 

A $383,278 million funding level is requested by President Carter for 
the National Institute of Mental Health for fiscal 1978, an increase 
over the Ford request of $375,911 million for fiscal 1978, However, this 
falls short of the $400,295 million appropriated by the Congress for 
fiscal 1977. The bulk of the cuts are in training funds which have been 
reduced from $69 million in fiscal 1977 to a proposed $38 million in 
fiscal 1978 under both the Carter and Ford proposals. 

In past years, approximately 5 percent of the total NIMH budget 
has been used for aging research and related programs. 

Community Education Programs Continued at $3,553 Million 

The Ford and Carter budgets request $3,553 million for community 
education programs, the same amount as appropriated in fiscal 1977. 
This funding will support about 95 to 100 community education pro- 
grams in local school districts, State educational agencies, and univer- 
sities and colleges. 

$50 Million Increase Proposed for Legal Services Corporation 

The Carter administration recommends *]7. r j million for the Legal 
Services Corporation for fiscal year 197X, $83 million above the Ford 
budget request and $. r )0 million over the fiscal venr 1977 appropriation 



11 

of S125 million. The Corporation estimates that the increase will allow 
legal services attorneys to serve an additional 6 million clients over the 
1977 estimate of 13 million low-income persons. 

Small Increase for National Institute on Aging Recommended 

For fiscal 1978, the Ford and Carter budgets include an increase of 
$4.5 million for the National Institute on Aging over the fiscal year 
1977 appropriations of $30 million. The $34.5 million would be used 
to fund both extramural and intramural research and training — 
specifically about 339 grants, contracts, and training fellowships. This 
is an increase over the 290 awards expected to be made during 1977. 

Food Stamp Cutbacks Rescinded in Carter Budget 

The Carter budget calls for $5,627 billion for the food stamp pro- 
gram for fiscal 1978 and deletes the Ford administration's legislative 
proposal to reduce that amount by $882 million. The number of 
participants in the program for fiscal year 1978 is estimated at 17.5 
million at the beginning of the period. It is expected to drop to 17.2 
million by the end of fiscal year 1978. 

Title XX Social Services 

The Carter administration estimates that approximately $2.4 
billion will be used by the States under the $2.5 billion ceiling imposed 
upon title XX social services. Projections show that about 11 more 
States will be able to reach their Federal ceiling during 197S by 
meeting the 75-25 matching requirement. The Carter administration 
will propose legislation to extend the $200 million additional funds for 
the child day care standards. The Ford budget had not requested this 
extension. 

Home Health Demonstration Grants Program Continued 

Both the Carter and Ford budgets recommend $3 million in funding 
for the home health demonstration grant program which was funded 
by the Congress in fiscal 1977 at the same level. 

Railroad Retirement Annuities 

Payments for retirement, disability, and survivor benefits are pro- 
jected at $3,883 billion for fiscal year 1978, nearly $170 million above 
the fiscal yenv 1977 estimate of $3,714 billion. Actual payments during 
fiscal 3^ear 1976 totaled $3,469 billion. The number of persons on the 
rolls receiving monthlv benefit pavments will decrease slightlv from 
1,024,000 at the end of fiscal year 1976 to an estimated 1,022,000 at the 
end of 1977, with another slight decrease to 1,017,000 at the end of 
1978. There is no change in budget estimates for retirement annuities 
from the original Ford-proposed fiscal 1978 budget and the second 
Carter-proposed budget. 

Veterans Benefits for Older Americans 

Nearly $9 billion is projected to be expended in fiscal 1978 for 
Veterans' Administration non-service-connected disability pensions 



12 

(S3. 2 billion) and service-connected disability compensation payments 
15.8 billion). Of this total, veterans and survivors from World War I 
and prior conflicts are expected to receive $1.1 billion in pension pay- 
ments and S224 million in compensation payments for fiscal 197S. 
These figures will increase if cost-of-living increases proposed by 
President Carter are enacted by the Congress. He has recommended 
that compensation payments be raised by 4.9 percent effective October 
1. 1977, and that pensions be increased bv 5.3 percent on Januarv 1 
1978. 

The VA also operates the largest medical care deliver}- system in 
the Nation, with 172 hospitals. 16 domiciliary care units, 90 nursing 
homes, and 228 outpatient clinics in 1978. This system will treat 
more than 1.4 million patients in 197S, and fund 18.2 million out- 
patient medical and dental visits to VA and community facilities. 
Approximately $4.7 billion is projected to be expended. 



Type of care 



1976 
actual 



1977 
estimate 



1978 
estimate 



in "i home care: 
Patents treated 

ge daily nursing patient census. 

Domiciliary care: 

ten treated 

Average daily member census 

Community nursing home (contract care): 

Average daily nursing census 

Patients treated 

State home care (domiciliary): 

Average daily member census 

Members treated 

State nursing home care: 

Average da ly nursing census 

Patients treated 

State hospital care: 

Average daily patient census.. 

Pat ents treated 



10. 979 
6.992 


11,120 
7,335 


11,931 
7,870 


18,408 
9.090 


17,767 
9,065 


17, 767 
9,065 


6,645 
22,998 


8,000 
28,160 


8,500 
29, S20 


5.562 
11.544 


6,032 
13,270 


6,195 
13, 629 


4,245 
8,215 


5,207 
10,206 


5,630 
11,035 


1,022 
6,814 


1,050 
7,274 


1,050 

7,300 



Transportation 

Urban Mass Transportation Administration. — Section 16(b)(2) 
of the Urban Mass Transportation Act of 1964 reserves up to 2 per- 
cent of the annual allotment for capital assistance grants to private 
nonprofit groups for mass transportation services for elderly and 
handicapped individuals. 

Capita] assistance grants made pursuant to section 3 of the act are 
as follows: 1977 estimate. SI. 25 billion; January 1978 estimate, $1.25 
billion; revised 1978 estimate, SI. 35 billion. 

Thus, up to S25 million would be available in fiscal 1978 for 16(b 2 
grants under President Ford's January budget request. President 
Cart . Bed budget would raise that total to $27 million. 



Special Education 

The Ford and Carter fiscal 1978 budgets do not request funding for 
the older reader services program or education programs for non- 
English-speaking elderly. These programs were not funded in G 



13 

However, funds are requested for title I of the Library Services and 
Construction Act. Under that title, grants are made to libraries for 
model projects which serve primarily older persons. The Office of 
Education estimates that $2,415 million was expended on these 
grants in fiscal 1975, and $2,475 million in fiscal 1976. Nearly $2,475 
million is expected to be spent in fiscal 1977. The fiscal 1978 budgets 
project a $2,475 million spending level. 

o 



UNIVERSITY OF FLORIDA 

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